Gender-affirming Hormone Therapy and Changes in Kidney Function in Adults: A Retrospective Population-based Study

Area of Science:

• Endocrinology
• Nephrology
• Public Health

Background:

• Gender-affirming hormone therapy (GAHT) impacts body composition, but its effects on kidney function remain unclear.
• Understanding GAHT's renal impact is crucial for transgender and gender diverse (TGD) individuals' health.

Purpose of the Study:

• To investigate the association between GAHT and kidney function in TGD adults.
• To evaluate changes in serum creatinine, urine albumin-to-creatinine ratio, and risks of acute kidney injury, chronic kidney disease, and hypertension.

Main Methods:

• Retrospective observational cohort study using health administrative data from Manitoba, Canada (2007-2018).
• Compared TGD adults receiving GAHT versus those not, stratified by sex assigned at birth (AFAB and AMAB).
• Utilized multivariable regression and Cox proportional hazards models to assess outcomes up to 2 years post-prescription.

Main Results:

• In individuals assigned female at birth (AFAB) receiving GAHT, serum creatinine levels showed a statistically significant increase at 18 and 21 months compared to those without GAHT.
• No significant differences in creatinine changes were observed in individuals assigned male at birth (AMAB) receiving GAHT.
• Initiating GAHT was not associated with increased risks of incident chronic kidney disease or hypertension in either AFAB or AMAB individuals.

Conclusions:

• GAHT is associated with elevated serum creatinine levels in AFAB individuals.
• Further research is necessary to fully elucidate the long-term effects of GAHT on kidney function in TGD populations.